Deep Tendon Reflexes are measured on a scale with a normal patellar reflex grade. What is commonly considered normal?

• A. 0
• B. 2+
• C. 3+
• D. 5+

Answer: (B)

Deep tendon reflexes are graded on a simple 0–4 scale to express how strong a response is. For the patellar reflex, the normal level is 2+. This grade represents a normal, expected response — not too weak, not excessively brisk. A 0 would mean no reflex, which suggests an abnormality; a 1+ is diminished but present; a 3+ is brisk and may raise concern for hyperreflexia; and 4+ is very hyperactive, sometimes with clonus. The option of 5+ isn’t part of the standard grading system. So, 2+ is commonly considered the normal reflex grade.